Experience of Implementing a Cross-Border Primary Care Cooperation Project During the COVID-19 Pandemic: A Qualitative Study.

: The REACtion project was developed to provide nursing care to older adults at home within the primary care setting. The COVID-19 pandemic posed significant challenges to its implementation, acting both as a barrier and an opportunity. Although several studies have explored healthcare innovation during emergencies, there remains a need for strategic insights to guide real-world implementation efforts. This study aims to explore how the COVID-19 pandemic influenced the implementation of the REACtion project and identify the strategies adopted to ensure continuity and effectiveness in achieving its goals despite the challenges posed by the health emergency. : A qualitative descriptive study was conducted. Semi-structured interviews were carried out with nine project stakeholders, including nurses and researchers, between April and May 2023. The interviews were transcribed verbatim, read in-depth, and analyzed using content analysis to identify perceived barriers, facilitators, and strategies adopted during the project. : The pandemic shifted priorities from routine care to emergency health activities. Barriers to project implementation included social distancing, disruptions in the decision-making processes, and a general decline in community welfare. Despite these obstacles, the COVID-19 context underscored the central role of Family and Community Nurses in proactive primary care. Stakeholders adopted relationship-based strategies, addressed workforce shortages, and implemented measures to mitigate personal fatigue. : The implementation of innovative nursing interventions during emergencies requires adaptability, collaboration, and context-sensitive approaches. Strengthening stakeholder engagement and leveraging professional roles within the community are essential to overcoming barriers and seizing opportunities in crisis contexts.